Organization
LARRY PORTA LLC
Active
Other names
Larry Porta Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY PORTA LPC (OWNER)
(989) 448-2640
Entity
Organization
Contact information
Practice address
440 W MAIN ST STE C, GAYLORD, MI 49735-1885
(989) 448-2640
(989) 448-2639
Mailing address
440 W MAIN ST STE C, GAYLORD, MI 49735-1885
(989) 448-2640
(989) 448-2639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006513220001
—
MI
Enumeration date
09/16/2019
Last updated
09/16/2019
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